CN101444526B - Pharmaceutical composition - Google Patents
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- CN101444526B CN101444526B CN2008101639638A CN200810163963A CN101444526B CN 101444526 B CN101444526 B CN 101444526B CN 2008101639638 A CN2008101639638 A CN 2008101639638A CN 200810163963 A CN200810163963 A CN 200810163963A CN 101444526 B CN101444526 B CN 101444526B
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Abstract
The invention provides a pharmaceutical composition for expanding blood volume. The composition contains hydroxyethyl group starch and an electrolyte component. Content of components in the pharmaceutical composition is as follows: 55-65g/L of hydroxyethyl group starch 200/0.5, 120-145mmol/L of sodion, 3.5-5.5mmol/L of potassium ion, 1.0-3.5mmol/L of calcium ion, 96-125mmol/L of chloridion and 27-50mmol/L of acetate ion, and the pharmaceutical composition contains 0.7-1.25mmol/L of magnesian ion or does not contain the magnesian ion and contains 0.99g/L of glucose does not contain the glucose. The hydroxyethyl group starch is the hydroxyethyl group starch 200/0.5, the weight-average molecular weight of the hydroxyethyl group starch 200/0.5 ranges from 175,000 dalton to 225,000 dalton, and the mol substituted ratio of the hydroxyethyl group starch 200/0.5 ranges from 0.43 to 0.55.
Description
Technical field
The present invention relates to a kind of pharmaceutical composition, be specifically related to a kind of pharmaceutical composition that contains hetastarch 200/0.5 and balanced electrolyte solution, belong to field of pharmaceutical preparations.
Background technology
Therefore Hypovolemia is the ubiquitous problem of surgery patients peri-operation period, selects suitable class of liquids to carry out that volume treatment is most important safely and effectively.Using crystal, colloid, whole blood to carry out capacity clinically replenishes.Artificial in recent years colloid has obtained extensive use; Commonly used have dextran, hetastarch, gelatin or the like; Because the dilatation effect and the safety of hetastarch are ideal in various artificial colloids, become the most widely used plasma expander gradually in recent years.China just brings into use hetastarch 706 plasma substitutes (HES40/0.9), 706 plasma substitutes in the seventies be low-molecular-weight blood plasma extender, because molecular weight is little; Be excreted very soon behind the infusion; Thereby dilatation a little less than, the persistent period is short, and the clinical practice side reaction is more.The lots of clinical test confirms; Hetastarch 200/0.5 has toleration preferably, and according to the transfusion statistics of nearly 20000 examples, the incidence rate of anaphylaxis appearance reaction is minimum in the volume treatment; Be 0.058%, and serum albumin, dextran and gelatin are respectively 0.099%, 0.273% and 0.345%.
Using hetastarch clinically generally is to be dissolved in the normal saline to use; What use such as the HAES
of German Fresenius card ratio is hetastarch 200/0.5 sodium chloride injection; The HAES of Fresenius card ratio
is though be hetastarch 200/0.5 nominally; Its actual weight average molecular weight is that 240000 ± 50000 dalton and our national Specification 200000 ± 25000 dalton are distinguishing.Hetastarch 200/0.5 sodium chloride injection that also has our state approval to produce in addition all uses clinically in a large number.There is research to confirm to exist high chloro to thank to acidosic risk as the liquid on basis, should avoids at clinical a large amount of normal saline that use.
The pharmaceutical composition that Chinese patent " 200610091185.7 1 kinds are used for pharmaceutical composition of expanding blood volume and preparation method thereof " is mentioned is calcic not; But contain magnesium ion in the prescription; Reason is because the cause of incompatibility is really not so in the clinical use, because the incompatibility scope of magnesium and calcium ion and other drug is roughly the same; The incompatibility problem that calcium ion runs into, magnesium ion can run into equally.
Chinese patent " 200710000107.6 1 kinds of hydroxyethyl starch injection liquids and preparation method thereof "; The compositions that belongs to lactated Ringer's injection and hetastarch; Have clinical research to show with the sodium acetate Ringer's solution and compare, the patient of input sodium lactate ringer's liquid has the property crossed a blood lactate values to raise and blood pH value phenomenon on the low side.The present invention uses sodium acetate woods lattice electrolyte to replace the lactated Ringer's injection can avoid the blood lactate values to raise and blood pH value phenomenon on the low side.
Summary of the invention
The object of the present invention is to provide a kind of pharmaceutical composition that is used for expanding blood volume, contain hetastarch and electrolyte ingredient in the said compositions, electrolyte ingredient comprises sodium ion, potassium ion, chloride ion, calcium ion and acetate ion.
Further, pharmaceutical composition of the present invention, the weight average molecular weight of its contained hetastarch is 175000-225000 dalton, molar substitution is 0.43～0.55.
Further, pharmaceutical composition of the present invention, its hetastarch content range be: 55～65g/L.
Further, pharmaceutical composition of the present invention, the content of contained each composition is in its compositions:
Hetastarch 200/0.5 55～65g/L
Sodium ion 120～145mmol/L
Potassium ion 3.5～5.5.mmol/L
Calcium ion 1.0～3.5mmol/L
Chloride ion 96～125mmol/L
Acetate ion 27～50mmol/L
Pharmaceutical composition of the present invention also can further contain magnesium ion 0.7～1.25mmol/L in its compositions
Pharmaceutical composition of the present invention also can further contain glucose 0.99g/L in its compositions.
More particularly, the content of contained each composition is in the pharmaceutical composition of the present invention:
Hetastarch 200/0.5 60g/L
Sodium ion 130mmol/l
Potassium ion 5.5mmol/l
Calcium ion 1mmol/l
Magnesium ion 1mmol/l
Chloride ion 112.5mmol/l
Acetate ion 27mmol/l
Each component content of pharmaceutical composition of the present invention is:
Hetastarch 200/0.5 60g/L
Sodium ion 130mmol/l
Potassium ion 5.5mmol/l
Calcium ion 1mmol/l
Magnesium ion 1mmol/l
Chloride ion 112.5mmol/l
Acetate ion 27mmol/l
Glucose 0.99g/L
The present invention compares with hetastarch 200/0.5 sodium chloride that goes on the market; The actual weight average molecular weight of hetastarch 200/0.5 is 175000-225000 dalton; Molar substitution is 0.43～0.55; The HAES
of the Fresenius card ratio of listing is though be hetastarch 200/0.5 nominally at present; Its actual weight average molecular weight is 240000 ± 50000 dalton; These mean molecule quantity 200000 ± 25000 dalton with the hetastarch 200/0.5 that the present invention mentions are distinguishing; The mean molecule quantity of hetastarch 200/0.5 of the present invention descends about 40,000 than the mean molecule quantity of the hetastarch 200/0.5 of import, and molecular weight ranges is narrower, drops to bound 25000 dalton from limit 50000 dalton up and down.There are some researches show, hetastarch class plasma substitute medicine, if macromole part proportion of composing is high, it is just short that the time of pruritus sensation appears in the skin that so a kind of side effect is a human body when life-time service.Hetastarch 200/0.5 of the present invention is than the HAES
of Fresenius card ratio; The ratio of its macromole part in medicine is formed reduces on the one hand; The mean molecule quantity of macromole part also descends significantly on the one hand in addition; This point from the Fresenius card than the standard of the import registered standard of HAES
and SFDA of the present invention approval to just can draw; The regulation M90 of 200/0.5 pair of macromole part of the hetastarch of import registration is no more than 780000 dalton; And the M90 of the hetastarch 200/0.5 that the present invention mentions is no more than 600000 dalton, thereby the ratio that makes hetastarch 200/0.5 of the present invention the side effect of skin pruritus in life-time service, occur greatly reduces.In addition; Preparation hetastarch 200/0.5 sodium chloride injection forming with hetastarch of the present invention 200/0.5 and HAES
clinical research of Fresenius card ratio contrast; Through 3 centers, 128 routine multicenters, at random, blind method, the perspective parallel control clinical experimental study of positive drug draw to draw a conclusion: the hetastarch 200/0.5 sodium chloride injection 58 routine produce effects of test group Hangzhou Minsheng Pharmaceutical Group Co; 6 examples are effective, and total effective rate is 100%; The HAES of matched group Fresenius card ratio
produce effects 61 examples; Effective 3 examples, total effective rate are 100%.Hetastarch (200/0.5) sodium chloride injection of Hangzhou Minsheng Pharmaceutical Group Co's development is compared with the Hypovolemia that treatment wound, operative hemorrhage cause in prevention with the blood plasma substitute " He Si " of clinical practice, has identical effectiveness and safety.See the do not descend effectiveness of medicine of the decline of mean molecule quantity from above-mentioned clinical research contrast.See from the go on the market feedback information of clinical use of people's livelihood Pharmaceutical Group Co.,Ltd hetastarch 200/0.5 sodium chloride injection, use hetastarch 200/0.5 sodium chloride injection the skin pruritus phenomenon to occur and reduce the prolongation that the operating period existence is certain.
The present invention compares with existing hetastarch 200/0.5 sodium chloride; Reliable and stable capacity effect and the persistent period not only can be provided; And with sodium acetate and multiple electrolyte optimum organization, make it more near blood constituent, thereby more meet clinically " desirable colloid solution ".Calcium ions of the present invention, calcium are to keep human body normal physiological function and the necessary element of metabolism, between calcium constituent and cardiovascular function metabolism and pathology, the physiology substantial connection are arranged.Anesthesia Department of No.1 Clinical College, China Medical Univ. to 30 routine patient body's outer circulations during the variation of plasma calcium measure; Plasma calcium has downward trend with time CPB and hemodilution during the extracorporeal circulation; This decline may cause metabolism disorder; Promote plasma calcium concentration and make it restore to normal level, help myocardial function to recover.Excessive, the traffic overload problem of infusion liquid that calcium ions of the present invention can avoid capable more in addition infusion calcium ion to bring.The present invention can further contain magnesium ion.Magnesium ion is as cation important in the human body, and its peri-operation period metabolism disorder may exert an influence to clinical anesthesia.Anesthesia Department of BJ Union Hospital adopts at random, the clinical research methods of contrast, double blinding; Use sequential method up and down; Observe the influence that back blood plasma medium effective concentration (Cp50cal) is calculated in disappearance to propofol consciousness of venoclysis magnesium sulfate; Show that patients after surgery serum Mg-ion concentration can obviously reduce, the prompting peri-operation period should the Mg supplementation ion.During the operation on heart extracorporeal circulation during the variant outer circulation of blood plasma magnesium ion blood plasma magnesium significantly reduce; Mg supplementation can and be shut down the blood plasma magnesium ion during turn of tidal stream and was remained on normal level 0.8～1.2mmol/l in back 1 hour; Help controlling reperfusion injury of cardiac muscle; Antiarrhythmic effect is arranged, and Mg supplementation helps spontaneous rebeating behind the turn of tidal stream, should suitably replenish magnesia mixture during the prompting extracorporeal circulation.Compare with hetastarch 200/0.5 sodium chloride injection, the present invention just can avoid with acetate ion instead of part chloride ion because the acidosis of high chloro due to thanking with sodium acetate instead of part sodium chloride.
Compare the bad phenomenon that the lactic acid value raise and the blood pH value reduces when infusion hetastarch acetic acid ringer's injection can be avoided importing lactated Ringer's with hetastarch 200/0.5 lactated Ringer's injection.Clinically contrast has been done in the variation of input sodium lactate ringer's liquid and sodium acetate Ringer's solution blood lactate and vim and vigour; Method: the 40 examples patient that chooses date for operation is divided into sodium lactate group (L group) and sodium acetate group (A group) at random by table of random number; Every group of each 20 example adopt the compound general anesthesia of quiet suction.Input sodium lactate ringer's liquid in the L group art, input sodium acetate Ringer's solution in the A group art does not intersect in two groups of arts and imports other crystalloid fluids.Before observation is induced, induce back 1h, 2h, 3h and 4h blood lactate, SpO2, PETCO2, exhale last isoflurane concentration, exhale last N2O concentration, MAC and vim and vigour change.The result: two groups in age, sex, height, body weight, ASA classification, operating time, anesthesia duration, art the equal differences in aspect such as amount of infusion, amount of bleeding, urine amount do not have significance (P＞0.05).The lactate normal value is 0.50～2.22mmol/L.Induce preceding, as to induce back 1h, 2h, 3h, 4h blood lactate, SpO2, PETCO2, exhale last isoflurane concentration, exhale observation index such as last N2O concentration, MAC for two groups; Compare P＜0.05 (P=0.011) between group; Induce back 1h SpO2, lactate in the group and induce preceding relatively P＜0.05 (P=0.000); Induce back 4h MAC in the group, exhale last isoflurane concentration, exhale last N2O concentration and induce back 3h relatively, P＜0.05.Induce preceding, as to induce back 1h, 2h, 3h, 4h vim and vigour variation for two groups; Compare P＜0.05 (P=0.040) between group, induce back 2h pH in the group and induce back 1h, relatively P＜0.05 (P=0.015); Induce back 3h pH in the group and induce back 2h, relatively P＜0.05 (P=0.015).Conclusion: compare with input sodium acetate Ringer's solution in the art; The patient of input sodium lactate ringer's liquid has the property crossed a blood lactate values to raise and blood pH value phenomenon on the low side; Particularly patient's considered such as hepatic renal dysfunction, shock, anoxia, acidosis do not re-use lactated Ringer's; Should consider to import the sodium acetate Ringer's solution, based on this clinical comparison test, so the present invention replaces sodium lactate can further optimize " desirable colloid " with sodium acetate.
The specific embodiment
Below will combine embodiment to specify the present invention, but the embodiment of the invention only is used to technical scheme of the present invention is described, and non-limiting essence of the present invention.
Embodiment 1
Prescription:
Sodium ion 130mmol/L
Potassium ion 5.5mmol/L
Calcium ion 1.0mmol/L
Magnesium ion 1.0mmol/L
Chloride ion 112.5mmol/L
Acetate ion 27mmol/L
Hetastarch 60g/L
Method for preparing:
Water for injection is injected the container that band stirs, add 60g hetastarch 200/0.5, heated and stirred makes it abundant dissolving, and the back adds sodium chloride 6.34g; Potassium chloride 0.41g, two hydration calcium chloride 0.147g, magnesium chloride hexahydrate 0.203g, Sodium acetate trihydrate 3.67g, and stirring and dissolving; Add injection and be diluted with water to 1000ml, add proper amount of active carbon, stir, boil, be incubated 20 minutes; Use the titanium rod more successively, 0.45 micron micro-pore-film filtration, fill, high temperature sterilize promptly gets.
Embodiment 2
Prescription:
Sodium ion 130.7mmol/L
Potassium ion 4mmol/L
Calcium ion 1.0mmol/L
Chloride ion 108.7mmol/L
Acetate ion 28mmol/L
Hetastarch 60g/L
Method for preparing:
Water for injection is injected the container that band stirs, add 60g hetastarch 200/0.5, heated and stirred makes it abundant dissolving, and the back adds sodium chloride 6g; Potassium chloride 0.3g, two hydration calcium chloride 0.2g, Sodium acetate trihydrate 3.8g, and stirring and dissolving add injection and are diluted with water to 1000ml; Add proper amount of active carbon, stir, boil, be incubated 20 minutes, use the titanium rod more successively; 0.45 the micron micro-pore-film filtration, fill, high temperature sterilize gets final product.
Embodiment 3
Prescription:
Sodium ion 130mmol/L
Potassium ion 5.5mmol/L
Calcium ion 1.0mmol/L
Magnesium ion 1.0mmol/L
Chloride ion 112.5mmol/L
Acetate ion 27mmol/L
Glucose 0.99g/L
Hetastarch 60g/L
Method for preparing:
Water for injection is injected the container that band stirs, add 60g hetastarch 200/0.5, heated and stirred makes it abundant dissolving, and the back adds sodium chloride 6.34g; Potassium chloride 0.41g, two hydration calcium chloride 0.147g, magnesium chloride hexahydrate 0.203g, Sodium acetate trihydrate 3.67g, glucose 0.99g and stirring and dissolving; Add injection and be diluted with water to 1000ml, add proper amount of active carbon, stir, boil, be incubated 20 minutes; Use the titanium rod more successively, 0.45 micron micro-pore-film filtration, fill, high temperature sterilize promptly gets.
Embodiment 4
Prescription:
Sodium ion 136.5mmol/L
Potassium ion 4.0mmol/L
Calcium ion 1.8mmol/L
Chloride ion 110.2mmol/L
Acetate ion 33.9mmol/L
Glucose 0.99g/L
Hetastarch 60g/L
Method for preparing:
Water for injection is injected the container that band stirs, add 60g hetastarch 200/0.5, heated and stirred makes it abundant dissolving, and the back adds sodium chloride 6.0g; Potassium chloride 0.3g, two hydration calcium chloride 0.26g, Sodium acetate trihydrate 4.61g, glucose 0.99g and stirring and dissolving add injection and are diluted with water to 1000ml; Add proper amount of active carbon, stir, boil, be incubated 20 minutes, use the titanium rod more successively; 0.45 the micron micro-pore-film filtration, fill, high temperature sterilize promptly gets.
Embodiment 5
Prescription:
Sodium ion 136.4mmol/L
Potassium ion 4.0mmol/L
Calcium ion 1.8mmol/L
Magnesium ion 1.0mmol/L
Chloride ion 96mmol/L
Acetate ion 50mmol/L
Glucose 0.99g/L
Hetastarch 60g/L
Method for preparing:
Water for injection is injected the container that band stirs, add 60g hetastarch 200/0.5, heated and stirred makes it abundant dissolving, and the back adds sodium chloride 5.0g; Potassium chloride 0.3g, two hydration calcium chloride 0.26g, magnesium chloride hexahydrate 0.2g, Sodium acetate trihydrate 6.8g, glucose 0.99g and stirring and dissolving; Add injection and be diluted with water to 1000ml, add proper amount of active carbon, stir, boil, be incubated 20 minutes; Use the titanium rod more successively, 0.45 micron micro-pore-film filtration, fill, high temperature sterilize promptly gets.
Embodiment 6
Prescription:
Sodium ion 134.4mmol/L
Potassium ion 4.0mmol/L
Calcium ion 1.8mmol/L
Chloride ion 96mmol/L
Acetate ion 50mmol/L
Hetastarch 60g/L
Method for preparing:
Water for injection is injected the container that band stirs, add 60g hetastarch 200/0.5, heated and stirred makes it abundant dissolving, and the back adds sodium chloride 5.17g; Potassium chloride 0.3g, two hydration calcium chloride 0.26g, Sodium acetate trihydrate 6.8g, and stirring and dissolving add injection and are diluted with water to 1000ml; Add proper amount of active carbon, stir, boil, be incubated 20 minutes, use the titanium rod more successively; 0.45 the micron micro-pore-film filtration, fill, high temperature sterilize promptly gets.
Claims (4)
1. pharmaceutical composition that is used for expanding blood volume is characterized in that composed of the following components:
Hetastarch 200/0.5 55～65g/L
Sodium ion 120～145mmol/L
Potassium ion 3.5～5.5.mmol/L
Calcium ion 1.0～3.5mmol/L
Chloride ion 96～125mmol/L
Acetate ion 27～50mmol/L
Magnesium ion 0.7～1.25mmol/L
Wherein hetastarch is a hetastarch 200/0.5, and its weight average molecular weight is 175000-225000 dalton, and molar substitution is 0.43～0.55.
2. pharmaceutical composition according to claim 1 is characterized in that each components contents is:
Hetastarch 200/0.5 60g/L
Sodium ion 130mmol/l
Potassium ion 5.5mmol/l
Calcium ion 1mmol/l
Magnesium ion 1mmol/l
Chloride ion 112.5mmol/l
Acetate ion 27mmol/l.
3. pharmaceutical composition that is used for expanding blood volume is characterized in that composed of the following components:
Hetastarch 200/0.5 55～65g/L
Sodium ion 120～145mmol/L
Potassium ion 3.5～5.5.mmol/L
Calcium ion 1.0～3.5mmol/L
Chloride ion 96～125mmol/L
Acetate ion 27～50mmol/L
Magnesium ion 0.7～1.25mmol/L
Glucose 0.99g/L
Wherein hetastarch is a hetastarch 200/0.5, and its weight average molecular weight is 175000-225000 dalton, and molar substitution is 0.43～0.55.
4. pharmaceutical composition according to claim 3 is characterized in that each components contents is:
Hetastarch 200/0.5 60g/L
Sodium ion 130mmol/l
Potassium ion 5.5mmol/l
Calcium ion 1mmol/l
Magnesium ion 1mmol/l
Chloride ion 112.5mmol/l
Acetate ion 27mmol/l
Glucose 0.99g/L.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2008101639638A CN101444526B (en) | 2008-12-30 | 2008-12-30 | Pharmaceutical composition |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2008101639638A CN101444526B (en) | 2008-12-30 | 2008-12-30 | Pharmaceutical composition |
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| Publication Number | Publication Date |
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| CN101444526A CN101444526A (en) | 2009-06-03 |
| CN101444526B true CN101444526B (en) | 2012-06-27 |
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| CN2008101639638A Active CN101444526B (en) | 2008-12-30 | 2008-12-30 | Pharmaceutical composition |
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Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN102697717A (en) * | 2012-06-27 | 2012-10-03 | 青岛华仁药业股份有限公司 | Hydroxyethyl starch sodium chloride injection and preparation method thereof |
| CN103845358B (en) * | 2012-12-04 | 2015-11-25 | 江苏恒瑞医药股份有限公司 | Comprise the pharmaceutical composition of hetastarch and the electrolyte solution containing bicarbonate ion |
| CN103006555B (en) * | 2013-01-05 | 2014-08-06 | 四川美大康佳乐药业有限公司 | Hydroxyethyl starch injection and preparation method thereof |
| CN103494837B (en) * | 2013-10-10 | 2015-11-04 | 宋桂兰 | A kind of plasma volume expander compositions and preparation method thereof and application |
| CN103565736A (en) * | 2013-10-21 | 2014-02-12 | 湖北博瑞佳医药科技有限公司 | Hydroxyethyl starch 130 sodium acetate Ringer injection and preparation method thereof |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5702880A (en) * | 1993-06-04 | 1997-12-30 | Biotime, Inc. | Blood substitute comprising 0-5 mM K+ |
| CN1994316A (en) * | 2007-01-05 | 2007-07-11 | 李晓祥 | Hydroxyethyl starch injection liquid and preparation method thereof |
| CN101032512A (en) * | 2006-07-05 | 2007-09-12 | 北京费森尤斯卡比医药有限公司 | Medicine composition for expanding blood volume and the preparing method thereof |
-
2008
- 2008-12-30 CN CN2008101639638A patent/CN101444526B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5702880A (en) * | 1993-06-04 | 1997-12-30 | Biotime, Inc. | Blood substitute comprising 0-5 mM K+ |
| US6080538A (en) * | 1993-06-04 | 2000-06-27 | Biotime, Inc. | Plasma like solution and methods of use |
| CN101032512A (en) * | 2006-07-05 | 2007-09-12 | 北京费森尤斯卡比医药有限公司 | Medicine composition for expanding blood volume and the preparing method thereof |
| CN1994316A (en) * | 2007-01-05 | 2007-07-11 | 李晓祥 | Hydroxyethyl starch injection liquid and preparation method thereof |
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Address after: 310011 high tech Zone, 108 yuhangtang Road, Hangzhou City, Zhejiang Province Patentee after: Hangzhou Minsheng Pharmaceutical Co.,Ltd. Patentee after: HANGZHOU DISHENG PHARMACEUTICAL GROUP Co.,Ltd. Address before: 310011 high tech Zone, 108 yuhangtang Road, Hangzhou City, Zhejiang Province Patentee before: HANGZHOU MINSHENG PHARMACEUTICAL Co.,Ltd. Patentee before: HANGZHOU DISHENG PHARMACEUTICAL GROUP Co.,Ltd. |